{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T23:28:47Z","timestamp":1789946927294,"version":"4.0.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum D\u00fcsseldorf. Anstalt \u00f6ffentlichen Rechts"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and objectives<\/jats:title>\n                <jats:p>Postchemotherapy residual tumor resection (PC-RTR) is an important part of the multimodal treatment for patients with metastatic germ cell tumors. Simultaneous retroperitoneal and thoracic metastases often require consecutive surgical procedures. This study analyzes the histologic findings after abdominal and thoracic surgery in order to tailor the sequence and intensity of surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>From a total of 671 PC-RTRs from 2008 to 2021 we analyzed 50 patients with stage III non-seminomatous germ cell tumor (NSGCT) who had undergone both retroperitoneal and thoracic postchemotherapy residual tumor resection after first-line and salvage chemotherapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All patients included had stage III NSGCT. 39 and 11 patients received first-line and salvage chemotherapy, respectively. 45 (90%) patients received retroperitoneal resection first, followed by thoracic surgery. Three patients (6%) underwent thoracic surgery before retroperitoneal surgery and two patients (4%) underwent simultaneous surgery. Overall, the histology of retroperitoneal and thoracic specimens was discordant in 23% of cases. After first-line chemotherapy, of fourteen patients with necrosis in retroperitoneal histology, four patients had vital carcinoma in lung histology. In patients with teratoma in the retroperitoneum, the thoracic findings were concordant in most cases (78%). When teratomatous elements were also present in the orchiectomy specimen, concordance was 100%. After salvage chemotherapy, the discordance rate was 55%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The data presented in this study underline that retroperitoneal residual masses with necrosis cannot reliably predict histologic findings of thoracic specimens. Patients with teratoma in the retroperitoneum have a high likelihood of teratoma in the thoracic specimen.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-024-03467-6","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T11:03:13Z","timestamp":1721214193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Discordance of retroperitoneal and thoracic histologic findings in patients with metastatic germ cell tumors at postchemotherapy residual tumor resection"],"prefix":"10.1186","volume":"22","author":[{"given":"Yue","family":"Che","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"W\u00f6ltjen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Lusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Trainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Schirren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sponholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram Trudo","family":"Knoefel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Albers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Hiester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"issue":"35","key":"3467_CR1","doi-asserted-by":"publisher","first-page":"5603","DOI":"10.1200\/JCO.2007.13.6283","volume":"25","author":"BS Carver","year":"2007","unstructured":"Carver BS, Serio AM, Bajorin D, Motzer RJ, Stasi J, Bosl GJ, Vickers AJ, Sheinfeld J. Improved clinical outcome in recent years for men with metastatic nonseminomatous germ cell tumors. J Clin Oncol. 2007;25(35):5603\u20138. https:\/\/doi.org\/10.1200\/JCO.2007.13.6283.","journal-title":"J Clin Oncol"},{"issue":"2","key":"3467_CR2","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.eururo.2006.06.047","volume":"51","author":"Y Vergouwe","year":"2007","unstructured":"Vergouwe Y, Steyerberg EW, Foster RS, Sleijfer DT, Fossa SD, Gerl A, de Wit R, Roberts JT, Habbema JD. Predicting retroperitoneal histology in postchemotherapy testicular germ cell cancer: a model update and multicentre validation with more than 1000 patients. Eur Urol. 2007;51(2):424\u201332. https:\/\/doi.org\/10.1016\/j.eururo.2006.06.047.","journal-title":"Eur Urol"},{"issue":"4","key":"3467_CR3","doi-asserted-by":"publisher","first-page":"2334","DOI":"10.1007\/s00330-019-06495-z","volume":"30","author":"B Baessler","year":"2020","unstructured":"Baessler B, Nestler T, Pinto Dos Santos D, Paffenholz P, Zeuch V, Pfister D, Maintz D, Heidenreich A. Radiomics allows for detection of benign and malignant histopathology in patients with metastatic testicular germ cell tumors prior to post-chemotherapy retroperitoneal lymph node dissection. Eur Radiol. 2020;30(4):2334\u201345. https:\/\/doi.org\/10.1007\/s00330-019-06495-z.","journal-title":"Eur Radiol"},{"key":"3467_CR4","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1186\/1477-7819-10-203","volume":"10","author":"P Miranda Ede","year":"2012","unstructured":"Miranda Ede P, Abe DK, Nesrallah AJ, dos Reis ST, Crippa A, Srougi M, Dall\u2019Oglio MF. Predicting necrosis in residual mass analysis after retroperitoneal lymph node dissection: a retrospective study. World J Surg Oncol. 2012;10:203. https:\/\/doi.org\/10.1186\/1477-7819-10-203.","journal-title":"World J Surg Oncol"},{"issue":"5","key":"3467_CR5","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1097\/01.ju.0000120141.89737.90","volume":"171","author":"AA Mosharafa","year":"2004","unstructured":"Mosharafa AA, Foster RS, Koch MO, Bihrle R, Donohue JP. Complications of post-chemotherapy retroperitoneal lymph node dissection for testis cancer. J Urol. 2004;171(5):1839\u201341. https:\/\/doi.org\/10.1097\/01.ju.0000120141.89737.90.","journal-title":"J Urol"},{"issue":"4","key":"3467_CR6","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1002\/(sici)1098-2388(199912)17:4<263::aid-ssu7>3.0.co;2-6","volume":"17","author":"J Baniel","year":"1999","unstructured":"Baniel J, Sella A. Complications of retroperitoneal lymph node dissection in testicular cancer: primary and post-chemotherapy. Semin Surg Oncol. 1999;17(4):263\u20137. https:\/\/doi.org\/10.1002\/(sici)1098-2388(199912)17:4%3C263::aid-ssu7%3E3.0.co;2-6.","journal-title":"Semin Surg Oncol"},{"issue":"2","key":"3467_CR7","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.athoracsur.2007.09.020","volume":"85","author":"KA Kesler","year":"2008","unstructured":"Kesler KA, Rieger KM, Hammoud ZT, Kruter LE, Perkins SM, Turrentine MW, Schneider BP, Einhorn LH, Brown JW. A 25-year single institution experience with surgery for primary mediastinal nonseminomatous germ cell tumors. Ann Thorac Surg. 2008;85(2):371\u20138. https:\/\/doi.org\/10.1016\/j.athoracsur.2007.09.020.","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"3467_CR8","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1016\/S0022-5347(01)63169-0","volume":"159","author":"PG Tognoni","year":"1998","unstructured":"Tognoni PG, Foster RS, McGraw P, Heilman D, Bihrle R, Rowland RG, Wahle GR, Einhorn LH, Donohue JP. Combined post-chemotherapy retroperitoneal lymph node dissection and resection of chest tumor under the same anesthetic is appropriate based on morbidity and tumor pathology. J Urol. 1998;159(6):1833\u20135.","journal-title":"J Urol"},{"issue":"6","key":"3467_CR9","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1055\/s-0031-1299584","volume":"60","author":"J Schirren","year":"2012","unstructured":"Schirren J, Trainer S, Eberlein M, Lorch A, Beyer J, Bolukbas S. The role of residual tumor resection in the management of nonseminomatous germ cell cancer of testicular origin. Thorac Cardiovasc Surg. 2012;60(6):405\u201312. https:\/\/doi.org\/10.1055\/s-0031-1299584.","journal-title":"Thorac Cardiovasc Surg"},{"issue":"2","key":"3467_CR10","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jtcvs.2008.09.032","volume":"137","author":"B Besse","year":"2009","unstructured":"Besse B, Grunenwald D, Flechon A, Caty A, Chevreau C, Culine S, Theodore C, Fizazi K. Nonseminomatous germ cell tumors: assessing the need for postchemotherapy contralateral pulmonary resection in patients with ipsilateral complete necrosis. J Thorac Cardiovasc Surg. 2009;137(2):448\u201352. https:\/\/doi.org\/10.1016\/j.jtcvs.2008.09.032.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"3467_CR11","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/s0022-5347(01)64506-3","volume":"158","author":"EW Steyerberg","year":"1997","unstructured":"Steyerberg EW, Donohue JP, Gerl A, Toner GC, Schraffordt Koops H, Fossa SD, Keizer HJ. Residual masses after chemotherapy for metastatic testicular cancer: the clinical implications of the association between retroperitoneal and pulmonary histology. Re-analysis of Histology in Testicular Cancer (ReHiT) Study Group. J Urol. 1997;158(2):474\u20138. https:\/\/doi.org\/10.1016\/s0022-5347(01)64506-3.","journal-title":"J Urol"},{"issue":"4","key":"3467_CR12","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/j.athoracsur.2010.12.034","volume":"91","author":"KA Kesler","year":"2011","unstructured":"Kesler KA, Kruter LE, Perkins SM, Rieger KM, Sullivan KJ, Runyan ML, Brown JW, Einhorn LH. Survival after resection for metastatic testicular nonseminomatous germ cell cancer to the lung or mediastinum. Ann Thorac Surg. 2011;91(4):1085\u201393. https:\/\/doi.org\/10.1016\/j.athoracsur.2010.12.034. discussion 1093.","journal-title":"Ann Thorac Surg"},{"key":"3467_CR13","doi-asserted-by":"publisher","unstructured":"Kesler KA, Stram AR, Timsina LR, Turrentine MW, Brown JW, Einhorn LH. (2021) Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era. The Journal of thoracic and cardiovascular surgery 161 (6):1947\u20131959 e1941. https:\/\/doi.org\/10.1016\/j.jtcvs.2020.01.118.","DOI":"10.1016\/j.jtcvs.2020.01.118"},{"issue":"6","key":"3467_CR14","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/s0959-8049(96)00517-5","volume":"33","author":"JT Hartmann","year":"1997","unstructured":"Hartmann JT, Candelaria M, Kuczyk MA, Schmoll HJ, Bokemeyer C. Comparison of histological results from the resection of residual masses at different sites after chemotherapy for metastatic non-seminomatous germ cell tumours. Eur J Cancer. 1997;33(6):843\u20137. https:\/\/doi.org\/10.1016\/s0959-8049(96)00517-5.","journal-title":"Eur J Cancer"},{"key":"3467_CR15","doi-asserted-by":"publisher","unstructured":"Paffenholz PPD, Heidenreich A. (2017) Nonguideline concordant treatment of testicular cancer. Journal of Clinical Oncology 35, no 6_suppl. https:\/\/doi.org\/10.1200\/JCO.2017.35.6_suppl.407.","DOI":"10.1200\/JCO.2017.35.6_suppl.407"},{"issue":"30","key":"3467_CR16","doi-asserted-by":"publisher","first-page":"3752","DOI":"10.1200\/JCO.2012.43.4431","volume":"30","author":"HS Haugnes","year":"2012","unstructured":"Haugnes HS, Bosl GJ, Boer H, Gietema JA, Brydoy M, Oldenburg J, Dahl AA, Bremnes RM, Fossa SD. Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up. J Clin Oncol. 2012;30(30):3752\u201363. https:\/\/doi.org\/10.1200\/JCO.2012.43.4431.","journal-title":"J Clin Oncol"},{"issue":"1","key":"3467_CR17","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1002\/ijc.32704","volume":"147","author":"R Hellesnes","year":"2020","unstructured":"Hellesnes R, Kvammen O, Myklebust TA, Bremnes RM, Karlsdottir A, Negaard HFS, Tandstad T, Wilsgaard T, Fossa SD, Haugnes HS. Continuing increased risk of second cancer in long-term testicular cancer survivors after treatment in the cisplatin era. Int J Cancer. 2020;147(1):21\u201332. https:\/\/doi.org\/10.1002\/ijc.32704.","journal-title":"Int J Cancer"},{"issue":"4","key":"3467_CR18","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1053\/suro.2002.36977","volume":"20","author":"J Sheinfeld","year":"2002","unstructured":"Sheinfeld J. The role of adjunctive postchemotherapy surgery for nonseminomatous germ-cell tumors: current concepts and controversies. Semin Urol Oncol. 2002;20(4):262\u201371. https:\/\/doi.org\/10.1053\/suro.2002.36977.","journal-title":"Semin Urol Oncol"},{"issue":"6","key":"3467_CR19","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/j.eururo.2015.07.044","volume":"68","author":"P Albers","year":"2015","unstructured":"Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP, Nicolai N, Oldenburg J, European Association of U. Guidelines on testicular Cancer: 2015 update. Eur Urol. 2015;68(6):1054\u201368. https:\/\/doi.org\/10.1016\/j.eururo.2015.07.044.","journal-title":"Eur Urol"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03467-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-024-03467-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03467-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T11:08:59Z","timestamp":1721214539000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-024-03467-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3467"],"URL":"https:\/\/doi.org\/10.1186\/s12957-024-03467-6","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,17]]},"assertion":[{"value":"24 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was approved by the local ethic committee (2019\u2009\u2212\u2009720) of the University Hospital D\u00fcsseldorf of the Heinrich Heine University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All authors disclose any conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"185"}}